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I assume just the materials. I've never been keen on composite pedals, ive always figured they'd be weaker...maybe they aren't. For giving it a go I assume they are identical.
7's have adjustable pins for more or less grip/shin damage.
The 7's can be easily refurbed with a relatively cheap kit....if you can find it.
I used to get unbearable finger pain on long descents (at the joints), a combo between death gripping and thin grips. I now use ODI Rogues which are pretty fat and I'm more confident so less death grippage. Also, one finger breaking so good hold on the bars. Do you have a particularly weird bar shape?
Dropper posts obviously help with the danger of getting booted up the arse and over the bars on steep to moderate descents but also with the left, right movement which is part of good cornering technique. Letting the bike lean underneath you into the corner etc basically having all that space between your legs is letting the bike move about like a mad thing while you're solid and also loose on top. So, I'd say just getting used to it is right.
My feet can ache first time on the MTB in a while, as we know road shoes are stiff as and flat five tens are not. I use Shimano AM9 with XTR spds on gravel bike so kinda in-between but a lot stiffer than FiveTens with no issue.
I ride FiveTen Freerider and Crank Bros Stamp 7's in the large variation and they are big (im only UK10). Ultimately though, foot ache isn't an issue, cant remember it really bothering me recently. Less foot wrap on the pedal, I assumed, helps with foot pain. That was my thoughts in getting big pedals and seems to have worked.